Background: Breast implants come in variety of options from different filler materials (saline vs silicone), sizes and varying projections. (height to width ratios) One additional implant option is that of shape. (round vs teardrop/anatomic) For the typical patient this many breast implant options can be bewildering so it is helpful if the patient goes through a step by step algorithm.
The first step in the algorithm is to decide implant type. (saline vs. silicone) Once the implant type is chosen the next choice is that of size. I find volumetric sizers work best for this very important and patient-focused selection. The third choice is implant shape. (round vs shaped) This choice is best determined by the patient deciding whether they like a very full and round breast augmentation result or whether they want less upper pole fullness. While there are numerous other factors that influence breast shape (size of implant, amount of natural breast tissue and skin quality), implant shape does play a role.
The shaped or anatomic breast implant is specifically designed to create a less round breast augmentation/reconstruction look. By making the implant shell have a teardrop shape, nearly two-thirds of the implant volume is located on the bottom half. This makes the upper half of the implant have a sloped appearance. This has given rise to numerous names for it…including anatomic, tear drop or natural breast implant. All names refer to the same implant concept.
Case Study: This 42 year-old female desired breast implants and she was interested in a ‘natural look’. Using a volumetric implant sizing system, she choose around a 400cc implant size for her 5’5” and 150lb body frame. She had very little breast tissue and a little bit of sag to her small breasts. Because of her body and chest shape I choose for her round base anatomic implants also using her breast base width as a guide. (13 cms)
Under general anesthesia, she had anatomic shaped medium profile gummy bear silicone breast implants placed in a dual plane position through inframammary incisions.. Her thin breast tissues were easily expanded by the implants. Her inframammary folds were lowered to accommodate the base diameter of the implants.
Her postoperative results showed a major change in the size of her breasts and in the appearance of her chest. Even at this early point after surgery her breasts did not look too round or full. She had a rapid recovery and returned to work as an office in less than one week after surgery.
Breast augmentation today takes into consideration the type of breast shape that a woman wants. Women generally want either a rounder fuller breasts (obvious augmented breast) or a more natural look. (less upper pole fullness) The anatomic implant can provide a more natural breast augmentation result. It will always be a textured type implant as maintenance of implant position by capsular adhesion is important to prevent impamt rotation and breast shape distortion.
Highlights:
1) Anatomic breast implants ensure that there is less resultant upper pole fullness creating a more natural (less round) breast look.
2) Anatomic breast implants are textured and will feel slightly more firm than non-textured silicone gel implants.
3) Anatomic breast implants are usually best placed through an inframammary incisional approach to ensure vertical implant orientation.
Dr. Barry Eppley
Indianapolis, Indiana